Systems and methods for aligning an elongate member with an access site

ABSTRACT

Described herein are systems and methods for aligning an elongate member with an access site. An alignment system for controlling an alignment of a robotically controlled elongate member at an access site on a patient may include a longitudinal support rail and support arms coupled with and extending from the longitudinal support rail to form an alignment joint. One or more of the support arms may be configured to maintain the alignment of the elongate member with the access site during a surgical procedure. A method of aligning an elongate member with an access site may include determining a position of a stabilizer of an alignment joint and the access site on a patient, coupling the stabilizer to the access site on the patient, and automatically aligning the instrument driver with the stabilizer on the patient.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.14/880,024, titled “Systems and Methods for Aligning an Elongate Memberwith an Access Site,” filed Oct. 9, 2015, which claims priority to U.S.Provisional Application No. 62/061,820, titled “Systems and Methods forAligning an Elongate Member with an Access Site,” filed on Oct. 9, 2014.The disclosure of each of the above-referenced patent applications ishereby incorporated by reference in its entirety herein.

This application is related to U.S. patent application Ser. Nos.13/174,563, titled “Anti-Buckling Mechanisms and Methods,” filed on Jun.30, 2011; 13/803,535, titled “Active Drives for Robotic CatheterManipulators,” filed on Mar. 14, 2013; 13/803,627, titled “Active Drivesfor Robotic Catheter Manipulators,” filed on Mar. 14, 2013; 13/801,957,titled “Selective Grip Device for Drive Mechanism,” filed on Mar. 13,2013; 13/832,352, titled “Catheter Insertion System and Method ofFabrication,” filed on Mar. 15, 2013; 13/833,531, titled “RotationalSupport for an Elongate Member,” filed on Mar. 15, 2013; 13/835,136,titled “Active Drive Mechanism for Simultaneous Rotation andTranslation,” filed on Mar. 15, 2013; 13/839,967, titled “VascularRemote Catheter Manipulator,” filed on Mar. 15, 2013; and 13/838,777,titled “Active Drive Mechanism with Finite Range of Motion,” filed onMar. 15, 2013. This application is also related to U.S. Pat. No.8,602,031, titled “Modular Interfaces and Drive Actuation ThroughBarrier,” filed on Jan. 12, 2009; and U.S. Pat. No. 7,789,874, titled“Support Assembly for Robotic Catheter System,” filed on Jul. 1, 2005.All of the above-referenced patents and patent applications are herebyincorporated herein by reference in their entirety.

INCORPORATION BY REFERENCE

All publications and patent applications mentioned in this specificationare herein incorporated by reference in their entirety, as if eachindividual publication or patent application was specifically andindividually indicated to be incorporated by reference in its entirety.

TECHNICAL FIELD

This invention relates generally to the surgical robotics field, andmore specifically to a new and useful system and method for using analignment joint.

BACKGROUND

Robotic surgical systems and devices are well suited for use inperforming minimally invasive medical procedures, as opposed toconventional techniques that may require large incisions to open thepatient's body cavity to provide the surgeon with access to internalorgans. For example, a robotic surgical system may be used to facilitateimaging, diagnosis, and treatment of tissues that may lie deep within apatient or that may be preferably accessed only via naturally occurringpathways such as blood vessels or the gastrointestinal tract. One suchrobotic surgical system that may be used in such a minimally invasiveprocedure is a robotic catheter system. A robotic catheter system uses arobot, external to the patient's body cavity, to insert a catheterthrough a small incision in a patient's body cavity and guide thecatheter to a location of interest.

Typically, elongate members, for example catheters, are inserted into abody of a patient through a small incision or access site. Theinstrument driver driving the elongate member is aligned with the accesssite using a device, such as a stabilizer, as described in pending U.S.patent application Ser. No. 13/174,563 (publication numberUS2012/0071895), which is herein incorporated by reference. However,significant time is spent aligning the instrument driver with theinsertion site using the stabilizer. The typical process requires theuser to “train” the instrument driver with the location of the accesssite prior to loading the elongate member at the start of a procedure.This training process involves advancing the instrument driver forwardto mark an access site position. Once the instrument driver has beentrained, it must then be retracted to a starting position to load on theelongate member. The purpose of this training process is to notify theinstrument driver of the location of the access site, such that when itis advancing later with the elongate member attached, it has a knowntarget location. This training process is not a preferred process,because it is time consuming prior to each robotic procedure. It is akinto doing a trial run of each robotic procedure before the start of theprocedure. In addition, once the instrument driver has been trained withthe access site location, and once the stabilizer is adhered to theinsertion site of the patient, the stabilizer cannot be repositioned,even if the patient moves and the instrument driver needs to berepositioned. Further, it is difficult to adhere the stabilizer to skinthat is damp, moist or flaccid, for example due to age or weight of thepatient.

Thus, there is a need for a new and useful system and method foraligning an elongate member with an access site. This invention providessuch a new and useful system and method.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a stabilizer, in accordance with one embodiment;

FIGS. 2A-D illustrate perspective views of a surgical system having analignment joint, in accordance with one embodiment;

FIGS. 3A-E illustrate perspective views of an alignment joint, inaccordance with one embodiment;

FIG. 4 illustrates an instrument driver and revolute joint, inaccordance with one embodiment; and

FIG. 5 is a flow chart of a method of aligning an elongate member withan access site, in accordance with one embodiment.

DETAILED DESCRIPTION

The following description of various embodiments of the invention is notintended to limit the invention to these embodiments, but rather toenable any person skilled in the art to make and use this invention.

Described herein are systems and methods for aligning an elongate memberwith an access site. An elongate member may include a guidewire, sheath,leader, catheter, probe, needle, or any other type of device. Asdescribed herein, an elongate member may be aligned with an access siteof a patient. An access site may include a port in an artery or vein ora natural orifice, such as the gastrointestinal tract, esophagus,trachea, or any other type of site. In some embodiments, an elongatemember may be aligned with an access site using a stabilizer. Thestabilizer may be attached, coupled, adhered, or otherwise anchored tothe skin of a patient around or near an access site. The stabilizer mayinclude a slot, hole, eyelet, or other opening for receiving the distalend of the elongate member. A distal end of the elongate member may beinserted into the access site of the patient through the stabilizer.

In some embodiments, the stabilizer may be coupled to an alignmentjoint. The alignment joint supporting the stabilizer may be encoded orinclude one or more position sensors, such that a position of the accesssite marked by the stabilizer may be communicated to an instrumentdriver, active drive device, or anti-buckling device. In someembodiments, a position may be communicated through Wi-Fi, Bluetooth, ahardwired connection, and/or any other communication protocol known toone skilled in the art.

In some embodiments, an elongate member may be driven into the accesssite of the patient by an instrument driver or active drive device. Theinstrument driver or active drive device may be attached, coupled, orotherwise fastened to the stabilizer at the access site of the patient.Alternatively, an anti-buckling device for supporting the elongatemember may be attached, coupled, or otherwise fastened to the stabilizerat the access site of the patient.

FIG. 1 illustrates a stabilizer 502, in accordance with one embodiment.The stabilizer 502 preferably functions to couple to an alignment jointand to align an elongate member with an access site of the patient. Asshown in FIG. 1, the stabilizer 502 may include a base 560 for couplingwith the alignment joint. Further, the base 560 may include adhesive atits bottom side for attachment to a patient's skin. In some embodiments,the stabilizer 502 further includes a connector 562 for coupling with aninstrument driver, active drive device, or anti-buckling mechanism. Insome embodiments, the base 560 may be a high-density polyethylene (HDPE)platform that includes a strain relief material underneath for providingtransition from the rigid HDPE material to the patient skin. In someembodiments, the base 560 may also include a butterfly peel-away liner(e.g., tear-resistant HDPE liner) that covers the adhesive material atthe bottom side of the platform. During use, the liner may be peeledaway to expose the adhesive at the bottom side of the base 560. Thestabilizer 502 may also include an opening 564 formed at the base 560for allowing the elongate member to reach the patient's skin. Theopening 564 may include a pair of slots 566 for receiving one or moreprotrusions from an instrument drive, active drive device, oranti-buckling device.

Turning now to FIGS. 2A-2D, an exemplary alignment system 100 isillustrated. As shown in FIG. 2A, an alignment system 100 forcontrolling an alignment of a robotically controlled elongate member atan access site 1000 of a patient 999 may include a longitudinal supportrail 108 and one or more support arms coupled together to form analignment joint 106, which is coupled to and extends from thelongitudinal support rail 108. The alignment joint 106 may be configuredto reach the access site 1000 on the patient and to maintain thealignment of the elongate member with the access site 1000 during asurgical procedure. In some embodiments, the system 100 may furtherinclude a patient platform 104 configured to support the patient 999during a surgical procedure. An elongate member (not shown) may beinserted into the patient 999 at an access site 1000, as shown in FIGS.2A and 2B. The patient platform 104 may be supported by a floor support102, which may generally sit upon a floor of an operating room. In someembodiments, the alignment joint 106 and/or the longitudinal supportrail 108 may be draped with a sterile drape, as described in U.S. Pat.No. 8,602,031, which is herein incorporated by reference. In someembodiments, the alignment joint 106 and/or and the longitudinal supportrail 108 may maintain the alignment of the elongate member with theaccess site 1000 through the sterile drape.

In some embodiments, as shown in FIGS. 2A-2D, the system 100 may furtherinclude a stabilizer 103 coupled to a distal portion of one support armof the alignment joint 106. The stabilizer 103 may be configured tocouple the distal portion of one support arm of the alignment joint 106to the patient 999. In some embodiments, as shown in FIGS. 2A-2C, thealignment joint 106 may be configured to position a stabilizer 103 atthe access site 1000 of the patient 999. In operation, the alignmentjoint 106 may align a second support structure with the access site. Insome embodiments, a position of the access site 1000 may be communicatedby the alignment joint 106 to the second support structure. For example,a second support structure may include a revolute joint carrying aninstrument driver or a base of an active drive device. In someembodiments, a heading direction of the instrument driver or activedrive device may be adjustable, to ensure alignment of the elongatemember with the access site 1000. The alignment joint 106 may includeposition sensors, such that the alignment joint 106 may be used to alignan instrument driver or a revolute joint carrying the instrument driverwith the access site 1000 during a surgical procedure.

As shown in FIG. 2D, an alignment joint 106 may include a longitudinallyoriented support rail 108, such that the support rail 108 islongitudinally oriented with respect to the patient platform 104 andgeneral positioning of patient 999 thereon, as shown in FIGS. 2A and 2B.The support rail 108 may carry one or more support arms of the alignmentjoint 106. As shown in FIG. 2D, the one or more support arms may includea vertically extending arm 110, which is moveable along the longitudinalsupport rail 108. The vertically extending arm 110 may couple to anupper arm 112, which may be vertically adjustable with respect to thearm 110 and/or the patient platform 104. For example, the upper arm 112may include a rail section 122 that is received in a corresponding slot(not shown), allowing vertical movement of the upper arm 112.

In some embodiments, as shown in FIG. 2D, the one or more support armsof the alignment joint 106 may include a lateral arm assembly, which ispivotally supported on the upper arm 112. The lateral arm assembly maygenerally support the stabilizer 103 and facilitate movement of thestabilizer 103 across the patient platform 104, for example in adirection perpendicular to the longitudinal support rail 108 andalignment of the stabilizer with the access site 1000. As shown in FIG.2D, the one or more support arms of the alignment joint 106 may beadjustable in a yaw and/or pitch orientation. In some embodiments, asshown in FIG. 2D, the lateral arm assembly may include a pivoting armsupport 114, which is pivotally secured to the upper arm 112.Accordingly, the pivoting arm support 114 may facilitate yaw adjustmentof the alignment joint 106. Further, an extension arm 116 may bereceived within the pivoting arm support 114, and may be configured totranslate with respect to the pivoting arm support 114 to allowselective extension and retraction with respect to the pivoting armsupport 114. The stabilizer 103 may be maneuverable at a distal end ofthe extension arm 116 using a rotatable, tiltable, or pivotable joint118.

FIGS. 3A-3E illustrate various positions of the support arms of thealignment joint 106. As shown in FIG. 3A, the alignment joint 106 isillustrated initially with the extension arm 116 extended away from thepivoting arm 114. As shown in FIG. 3B, the extension arm 116 may movetoward the pivoting arm 114. In some embodiments, the extension arm 116may compress or accordion to be positioned in the pivoting arm 114.Alternatively, the length of the pivoting arm 114 may be substantiallyequal to the length of the extension arm 116, such that the pivoting arm114 receives the extension arm 116 in a slot of the pivoting arm 114. Asshown in FIG. 3C, the pivoting arm 114 may rotate about the upper arm112, and the upper arm 112 may also be lowered relative to thevertically extending arm 110. In some embodiments, as shown in FIG. 3D,the extension arm 116 may be extended from the pivoting arm 114 uponrotation of the pivoting arm 114 about the upper arm 112. Further, theupper arm 112 may be in an uppermost position, the extension arm 116 maybe in a partially extended position, and the joint 118 may be rotatedaway from the vertically extending arm 110. As shown in FIG. 3E, thepivoting arm 114 may be rotated about the upper arm 112 as compared withthe position shown in FIG. 3C. The vertically extending arm 110, upperarm 112, pivoting arm 114, extension arm 116, and joint 118 maygenerally be placed in any relative position that is desired,facilitating placement of the stabilizer 103 at or adjacent an accesssite (not shown in FIGS. 3A-3E) of a patient. Each component of thealignment joint may be rotatable, tiltable, or pivotable by a ball andsocket, knuckle, revolute, turnbuckle, or pin joint. Alternatively, oneor more joints may be fixed.

Further, movement of each of the support arms of the alignment joint 106may be remotely controllable, or otherwise capable of being manipulatedor moved by a user. For example, the alignment joint 106 may include oneor more position sensors for aligning a revolute joint carrying theinstrument driver with the location and/or position of the access site1000. Alternatively, the alignment joint 106 may include one or moreposition sensors for aligning an active drive device with the locationand/or position of the access site 1000. In some embodiments, angleand/or position encoders may be provided at each joint of the alignmentjoint 106, for example, between (a) the rail 108 and arm 110, (b) thearm 110 and upper arm 112, (c) the upper arm 112 and pivoting armsupport 114, (d) the pivoting arm support 114 and the extension arm 116,(e) the extension arm 116 and the joint 118, and/or (f) the joint 118and the stabilizer 103. Further, position of the stabilizer 103 relativeto the access site 1000, as well as the other components of thealignment joint 106, may be accurately determined.

In some embodiments, the various joints in the alignment joint 106 maybe manually lockable, for example to lock the alignment joint 106 orportions thereof into a fixed position. In this manner, portions of thealignment joint 106 may be held fixed while other portions are capableof being moved, for example to effect movement of an elongate member.Additionally, the alignment joint 106 may comprise one or more quickrelease switches to unlock the joints.

In some embodiments, movement of the instrument drive or active drivedevice may be effected by the alignment joint 106 and any component(s)thereof, during a surgical procedure. For example, moving the verticallyadjustable arm 110 up and down above the patient access site 1000 mayrobotically adjust the vertical position of the robotic catheter system,for example an instrument driver and/or elongate member. Additionally oralternatively, moving the laterally adjustable arm member 112, yawadjustable arm member 114, and longitudinally translatable base alongthe longitudinal rail 108 about the patient access site 1000 may resultin adjustment of the longitudinal and yaw position of the instrumentdriver, revolute joint, active drive device and/or components thereof.

In some embodiments, a system for aligning an elongate member with anaccess site may include a revolute joint, an alignment joint, and atleast one position sensor. A revolute joint may be configured to supportan instrument driver, such that the revolute joint is longitudinallytranslatable relative to an operating table and the instrument driver isconfigured to axially and laterally displace an elongate member. Analignment joint, as described above, may be longitudinally translatablerelative to the operating table and configured to align the elongatemember with the access site. In some embodiments, the at least oneposition sensor may provide feedback to the revolute joint, such thatthe revolute joint aligns the instrument driver with the access site andcommunicates the location of the access site with the instrument driversuch that the instrument driver knows when to stop advancing and not hitthe patient.

FIG. 4 illustrates an instrument driver 408 and a revolute joint 404positioned on a rail 407, in accordance with a system for aligning anelongate member with an access site. The system preferably functions toaxially and/or rotationally drive an elongate member into an access siteof a patient.

In some embodiments, as shown in FIG. 4, the instrument driver 408includes a catheter drivable assembly 182 for positioning a catheter,and a sheath drivable assembly 184 for positioning a sheath that isplaced coaxially around the catheter. In the illustrated embodiments,the sheath drivable assembly 184 is moveable relative to the catheterdrivable assembly 182. The instrument driver assembly 408 may furtherinclude a guide wire manipulator 410 for positioning a guidewire (notshown) that may be placed within a lumen of the catheter. In someembodiments, a stabilizer at an access site of the patient may be incommunication with the instrument driver, such that the elongate memberdriven by the instrument driver is aligned with the access site and willnot drive past the access site and injure the patient.

In some embodiments, the instrument driver 408 may further include twoanti-buckling devices 500 a, 500 b for preventing the buckling of thecatheter and the sheath during use. A coupler 501 at the distal end ofthe anti-buckling device 500 b may couple, attach, or fasten to astabilizer at the access site of the patient, as described above, suchthat the elongate member supported by the anti-buckling device isaligned with the access site.

In some embodiments, as shown in FIG. 4, the instrument drive 408 may besupported by a revolute joint 404. In some embodiments, the revolutejoint 404 may be mounted to the patient support (table) 22 via a railsystem 406. The rail system 406 may allow the revolute joint 404 (andtherefore, the instrument driver 408) to translate along the length ofthe patient support 22. In some embodiments, the rail system 406includes a motorized rail 407, which can be actuated to drive movementof the revolute joint 404. In other embodiments, other mechanisms may beused, including but not limited to a lead screw, a ball screw, linearmotor, belt, and/or cable drive, etc. In other embodiments, the revolutejoint 404 may be allowed to move by actuating a button at the revolutejoint 404, thereby releasing the revolute joint 404 from a lockedposition against the rail system 406. The revolute joint 404 can then betranslated manually along the axis of the patient support 22. When therevolute joint 404 has reached a desired position, the button may bereleased to lock the revolute joint 404 at the desired position. Therevolute joint has been described in U.S. Pat. No. 7,789,874, filed onJul. 1, 2005, the entire disclosure of which is expressly incorporatedby reference herein.

FIG. 5 illustrates one embodiment of a method for aligning an elongatemember, controlled by an instrument driver, with an access site.According to this embodiment, the method includes determining a positionof a stabilizer of an alignment joint and the access site on a patientS100; coupling the stabilizer to the access site on the patient S110;and automatically aligning the instrument driver with the stabilizer onthe patient S120. The method preferably functions to maintain alignmentof an elongate member with an access site of a patient during a surgicalprocedure.

As shown in FIG. 5, the method may involve determining a position of astabilizer of an alignment joint and the access site on a patient S100.In some embodiments, an alignment joint may include one or more positionsensors, such that a position of a stabilizer and thus an access sitemay be determined. The position of the access site may be communicatedto a revolute joint supporting an instrument driver or to a base of anactive drive device, such that the elongate member driven by theinstrument driver or active drive device may be aligned with the accesssite and not overrun the access site.

As shown in FIG. 5, the method may further involve coupling thestabilizer to the access site on the patient S110. Once a position ofthe access site is determined by one or more position sensors on thealignment joint, the stabilizer coupled to the alignment joint may beadhered, coupled, or otherwise fastened to the patient near the accesssite, such that the position of the stabilizer marks the access site.

As shown in FIG. 5, the method may also involve automatically aligningthe instrument driver with the stabilizer on the patient S120. Asdescribed above in step S110, the stabilizer marks a position of theaccess site. In some embodiments, the position of the access site may becommunicated to a revolute joint and/or instrument driver. Theinstrument driver may then be aligned with the stabilizer on thepatient, such that the elongate member driven by the instrument drivermay be aligned with the access site.

In some embodiments, the method of FIG. 5 may further include the stepof coupling an anti-buckling mechanism of an instrument driver or anactive drive device to the stabilizer of the alignment joint. Asdescribed above in connection with FIG. 4, an anti-buckling mechanismfor supporting the elongate member may be coupled to the stabilizer atthe access site, such that the elongate member may be driven into theaccess site. Alternatively, an active drive device may be coupled to thestabilizer. In some embodiments, the active drive device may axiallytranslate the elongate member towards an access site of a patient.Exemplary active drive devices are described in pending U.S. patentapplication Ser. Nos. 13/803,535; 13/803,627; 13/801,957; 13/832,352;13/833,531; 13/835,136; 13/839,967; and 13/838,777, each of which areherein incorporated by reference.

In some embodiments, the method of FIG. 5 may further includeautomatically adjusting an alignment of the stabilizer with the accesssite if the access site changes position (for example, if the patientmoves on the table). In some embodiments, the method may further includeautomatically adjusting an alignment of the instrument driver with thestabilizer if the stabilizer changes position.

It will be appreciated that the mechanisms and methods described hereinhave broad applications. The foregoing embodiments were chosen anddescribed in order to illustrate principles of the methods andapparatuses as well as some practical applications. The precedingdescription enables others skilled in the art to utilize methods andapparatuses in various embodiments and with various modifications as aresuited to the particular use contemplated. In accordance with theprovisions of the patent statutes, the principles and modes of operationof this disclosure have been explained and illustrated in exemplaryembodiments.

It is intended that the scope of the present methods and apparatuses bedefined by the following claims. However, this disclosure may bepracticed otherwise than is specifically explained and illustrated,without departing from its spirit or scope. Various alternatives to theembodiments described herein may be employed in practicing the claims,without departing from the spirit and scope as defined in the followingclaims. The scope of the disclosure should be determined, not withreference to the above description, but instead with reference to theappended claims, along with the full scope of equivalents to which suchclaims are entitled. It is anticipated and intended that futuredevelopments will occur in the arts discussed herein, and that thedisclosed systems and methods will be incorporated into such futureexamples. Furthermore, all terms used in the claims are intended to begiven their broadest reasonable constructions and their ordinarymeanings as understood by those skilled in the art unless an explicitindication to the contrary is made herein. In particular, use of thesingular articles such as “a,” “the,” “said,” etc. should be read torecite one or more of the indicated elements unless a claim recites anexplicit limitation to the contrary. It is intended that the followingclaims define the scope of the invention and that the method andapparatus within the scope of these claims and their equivalents becovered thereby. In sum, it should be understood that the invention iscapable of modification and variation and is limited only by thefollowing claims.

What is claimed is:
 1. A robotic medical system, comprising: multiplesupport arms forming an alignment joint, wherein the support arms areconfigured to reach an access site on a patient, and wherein the supportarms are configured to maintain the alignment of a roboticallycontrolled elongate member with the access site during a surgicalprocedure; a stabilizer comprising: a base with an opening formedtherethrough for receiving the elongate member, and a connector thatcouples an active drive device to the stabilizer, the active drivedevice configured to control the elongate member; and a port configuredto be inserted at the access site, wherein the stabilizer is alignedwith the port, wherein one of the support arms is configured to beattached to the stabilizer to support and facilitate rotational movementof the stabilizer with respect to the support arm when the stabilizer isattached to the support arm.
 2. The system of claim 1, furthercomprising: a longitudinal support rail attached to a patient support,wherein one of the support arms is coupled with the longitudinal supportrail and the alignment joint extends from the longitudinal support rail.3. The system of claim 2, wherein the support arms and the longitudinalsupport rail are draped with a sterile drape.
 4. The system of claim 3,wherein the support arms and the longitudinal support rail maintain thealignment of the elongate member through the sterile drape.
 5. Thesystem of claim 1, wherein the support arms form at least one rotatablejoint configured to adjust a yaw orientation of the elongate member. 6.The system of claim 1, wherein at least one of the support arms isadjustable in a yaw orientation.
 7. The system of claim 1, wherein atleast one of the support arms is adjustable in a pitch orientation. 8.The system of claim 1, wherein the stabilizer is coupled to a distalportion of one of the support arms.
 9. The system of claim 1, whereinthe stabilizer is coupled to a distal portion of one of the supportarms, and further comprising an anti-buckling device coupled to thestabilizer and supporting the elongate member.
 10. The system of claim1, wherein the active drive device is coupled to a distal portion of oneof the support arms, and wherein the active drive device is configuredto insert and retract the elongate member.
 11. The system of claim 1,further comprising at least one sensor configured to determine aposition of the access site.
 12. The system of claim 11, furthercomprising an instrument driver on a second support structure, wherein aposition of the access site is communicated to the second supportstructure, and a heading direction of the instrument driver isadjustable to ensure alignment of the elongate member with the accesssite.
 13. A system, comprising: a revolute joint configured to supportan instrument driver, wherein the instrument driver is configured tocontrol movement of an elongate member; an alignment joint coupled tothe revolute joint, wherein the alignment joint is configured to alignthe elongate member with an access site on a patient, the alignmentjoint comprising one or more position sensors, wherein an output of theone or more position sensors is indicative of a position of thealignment joint; and a stabilizer configured to be attached to thepatient, wherein the stabilizer comprises a base with an opening formedtherethrough for receiving the elongate member, wherein the output ofthe one or more position sensors is further indicative of a position ofthe stabilizer, wherein the system is configured to determine theposition of the stabilizer based on the output of the one or moreposition sensors, and automatically move the revolute joint to align theinstrument driver with the stabilizer based on the determined positionof the stabilizer.
 14. The system of claim 13, wherein the stabilizer isconfigured to couple to an anti-buckling mechanism of the elongatemember.
 15. The system of claim 13, further comprising an active drivedevice attached to the stabilizer, wherein the active drive device isconfigured to insert and retract the elongate member.
 16. The system ofclaim 13, wherein the stabilizer is coupled to the alignment joint. 17.A system, comprising: an alignment joint configured to align an elongatemember with an access site on a patient; an active drive device coupledto the alignment joint, wherein the active drive device is configured tomanipulate the elongate member at the access site; and a stabilizerconnected to the active drive device, wherein the stabilizer comprises abase with an opening formed therethrough for receiving the elongatemember, wherein the alignment joint is configured to be attached to thestabilizer to support and facilitate rotational movement of thestabilizer with respect to the support arm when the stabilizer isattached to the support arm.
 18. The system of claim 17, wherein theactive drive device is configured to axially translate the elongatemember.
 19. The system of claim 17, further comprising: a longitudinalsupport rail attached to a patient support, wherein the alignment jointis coupled with the longitudinal support rail and the alignment jointextends from the longitudinal support rail.
 20. The system of claim 19,wherein the alignment joint and the longitudinal support rail are drapedwith a sterile drape.